Based on a transactional model of stress, this study aims to understand the role played by attributions in selecting surface acting as emotion regulation strategy when coping with emotion-rule dissonance. A sample of primary health care professionals (n = 87) based in Madrid filled in a questionnaire. Hierarchical multiple regression analyses were conducted to test hypotheses on the moderating effects of attributions on the relationship between emotion-rule dissonance and surface acting. Results showed that high levels of attribution to patients of responsibility for negative events, low levels of professionals' self-accountability, and low attribution of being able to promote a positive change strengthen the positive association between emotion-rule dissonance and surface acting. This could explain why professionals use a potentially damaging emotion regulation strategy.